Neck Disability Index Questionnaire Research Articles

Prevalence and Interrelationships of Screen Time, Visual Disorders, and Neck Pain Among University Students: A Cross-Sectional Study at Majmaah University.

Digital devices significantly contribute to vision-related problems. In addition, prolonged postural imbalance, owing to excessive use of digital devices, can lead to the tightening of head and neck muscles, resulting in neck pain, a common musculoskeletal discomfort that significantly affects individuals with poor vision. This study aimed to evaluate the prevalence and interrelationships of screen time, visual disorders, and neck pain among students at Majmaah University. A cross-sectional study was conducted at Majmaah University, Saudi Arabia, enrolling students aged 18 to 25 years. Exclusion criteria included neurological or musculoskeletal disorders. Demographic data and information on visual and neck pain symptoms were collected. The Neck Disability Index questionnaire was used to assess neck pain, and data were analyzed using SPSS version 24.0. Among 263 participants, 53.6% were female. Nearsightedness (38.0%) and dry/itchy eyes (49.0%) were the most common visual disorders and symptoms, respectively. Visual disorders were prevalent in 62.0% of students, while neck pain was reported by 79.5%. Females and those studying for more than 5 h using electronic screens daily reported higher neck disability index scores. A significant association was found between >5 h of study duration [screen time] and neck disability (OR 3.703, 95% CI 1.500-9.144, p = 0.005). The study highlights a relationship between visual problems and neck pain among university students, emphasizing the need for addressing vision-related issues to reduce neck discomfort. High screen time could substantially increase the odds of developing neck disability. However, authors warrant cautious interpretation in the light of following limitations: cross-sectional study, small sample size, lack of statistical power, and self-reported data.

Comparative effects of isometric and isotonic global neck muscles strengthening exercise programme on pain, range of motion, strength, function and quality of life in patients with chronic mechanical neck pain.

The randomised clinical current study was planned to determine the comparative effects of isometric and isotonic global neck muscles strengthening exercises on pain, range of motion, strength, function and quality of life in patients with chronic mechanical neck pain. The study comprised 22 patients with chronic mechanical neck pain. The subjects were randomly divided into two interventional groups, with group A receiving isometric exercises and group B receiving isotonic exercises. Numeric Pain Rating Scale, Neck Disability Index, goniometer, dynamometer and Short Form-36 questionnaire were used for data collection. Isometric and isotonic exercise groups showed significant improvement (p<0.05) in terms of decreasing pain and functional disability, and increasing range of motion and strength. Intergroup comparison showed no significant differences (p>0.05), indicating similar efficacy of isometric and isotonic global neck muscles strengthening exercises. This study was registered at ClinicalTrials.gov ID: NCT05865951.

Comparing the effects of neck stabilization exercises versus dynamic exercises among patients having nonspecific neck pain with forward head posture: a randomized clinical trial

BackgroundNonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual’s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion.MethodsIt is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant.ResultsAfter treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement.ConclusionBetween NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP.Trial RegistrationRegistered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

Prevalence of Neck Pain in Physiotherapist

Background: Neck pain is one of the most common musculoskeletal disorders among health professionals, including physiotherapists, who are often involved in activities that include holding a posture for a longer duration and performance of repetitive movements. The increased usage of smartphones and laptops enhances bad postures, particularly bending of the neck in flexion, adding to the problems related to neck pain. Objective: The present study has been taken up to assess the prevalence of neck pain among physiotherapists and their relation with gender and age. Methods: This was a cross-sectional study conducted on 100 physiotherapists, of which 63 were females and 37 were males. Neck pain prevalence was assessed with the Neck Disability Index questionnaire. Data collection was done in person from November 2023 to February 2024. Results were statistically analyzed, with descriptive statistics shown in tabulations, graphs, and figures. Results: The overall prevalence of neck pain among the participants was 64%. In accordance with the NDI scale, the physiotherapists self-reported 39% to have mild disability; 23%, moderate disability; only 2% were severely disabled and none with complete disability. On a gender basis, females revealed a slightly higher prevalence of neck pain, 25%, compared to their male counterparts, 24%. Conclusion: In this study, a high prevalence of neck pain was found among physiotherapists, with a slightly increased occurrence in females. These findings bring out the importance of increasing awareness toward ergonomic practices and health regarding posture to decrease neck pain in physiotherapists. The modifiable risk factors identified will have an emphasis on the promotion of good postures with lifestyle modifications to aid in the prevention of neck pain in physiotherapists. Making these changes and taking up appropriate treatments form an important aspect of the management of work-related musculoskeletal disorders.

Comparison of the clinical effectiveness of Class IV Laser therapy and therapeutic ultrasound in patients with chronic neck pain: a randomized controlled trial

INTRODUCTION: Chronic neck pain (CNP) is a common musculoskeletal problem that affects a large proportion of the population and lasts longer than three months. It has a high cost in terms of life, disability, and healthcare. Several modalities have effectively provided immediate and long-term relief for CNP; however, the comparative clinical effectiveness of these modalities is limited. OBJECTIVES: The study aimed to determine the clinical effectiveness of Class IV Laser therapy and Therapeutic Ultrasound (TUS) in patients with CNP. METHODS AND MATERIALS: Forty-four patients with CNP of both genders were recruited from an age range of 20–45 years from the Department of Musculoskeletal Physiotherapy of Maharishi Markandeshwar Institute of Physiotherapy, MM(DU), Ambala, India. They were divided into two groups at random: the LASER group A (n = 22) and the TUS group B (n = 22). The intervention duration was 2 weeks with 6 treatment sessions. Pre- and post-treatment outcome measures were assessed with the Visual Analog Scale (VAS), Algometer, Goniometer, and Neck Disability Index (NDI) questionnaires at baseline and after 2 weeks of intervention. The LASER group received a target dose of 10 joules per cm2 at a power of 10 watts, with a continuous dosage frequency. The TUS group underwent a continuous mode ultrasound (3 MHz, 1 W/cm2) for 6 minutes. The Shapiro-Wilk test was used to assess the normality of the data. For parametric and non-parametric data analysis within the group, the paired t-test and Wilcoxon signed rank were used. The independent t-test and Mann-U Whitney test were used for the group comparison of parametric and non-parametric data, respectively. RESULTS: In both groups, there was a significant improvement in all the outcome measures (p&lt;0.001). There was a statistically significant difference between the two interventions in VAS, Pain Pressure Threshold (PPT), and NDI (p&lt;0.05). CONCLUSION: Class IV Laser therapy is clinically more effective than therapeutic ultrasound in treating patients with chronic neck pain.

The relationship between sedentary lifestyle, neck disability, and high blood pressure among bankers

Background: A sedentary lifestyle greatly affects a person's life. Inactive lifestyle changes can result in increased neck disability. Sedentary behavior can also affect vascular, metabolic, and autonomic systems. This study aimed to determine the relationship between a sedentary lifestyle, neck disability, and high blood pressure in bank employees. Methods: The research method used is an observational analytical study with a cross-sectional approach and a sampling technique, namely purposive sampling. The number of samples obtained was 93 samples aged 18-55 years. The independent variable measured was sedentary lifestyle using the International Physical Activity Questionnaire (IPAQ) questionnaire. The dependent variables measured were neck disability using the Neck Disability Index (NDI) questionnaire and high blood pressure measured using a sphygmomanometer. Results: Based on the non-parametric Spearman Rho test, a value of p = 0.001 (p &lt; 0.05) was obtained, which showed that there was a significant relationship between a sedentary lifestyle and neck disability and high blood pressure and the value of the correlation coefficient ranging from r = -0.831 to -0.928 and negative values indicating an undirected relationship with a very high level of correlation. Based on the results of multivariate analysis with regression logistic tests showed a significant relationship between a sedentary lifestyle and neck disability and high blood pressure characterized by p values &lt; 0.05. Conclusion: Based on the study's results, there is a negative relationship between a sedentary lifestyle and neck disability and high blood pressure in bank employees. When a sedentary lifestyle shows low measurement results, it will indicate that the individual has a neck disability and high blood pressure.

Prevalence of Neck Pain and Associated Disabilities among Students who Use Computers

Background: Neck pain is increasingly prevalent among computer users, leading to significant health concerns and impacting daily activities. Understanding the prevalence and associated disabilities of neck pain in this population is crucial for developing effective preventive measures and interventions. Objective: To investigate the prevalence of neck pain and associated disabilities among university students who use computers, and to identify the factors contributing to these conditions. Methods: This cross-sectional study was conducted over six months at Akhtar Saeed Medical and Dental College, Lahore. A sample of 144 students from DPT, MBBS, BDS, and Pharm-D programs, aged 20-28 years, was selected. Participants included both males and females who used computers for more than two hours daily and had no history of cervical trauma or underlying medical conditions. Data were collected using the Neck Disability Index (NDI) questionnaire and the Numeric Pain Rating Scale (NPRS). Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants. Data analysis was performed using SPSS version 25, with descriptive statistics summarizing demographic information and inferential statistics examining associations between neck pain and risk factors. Results: The study found that 29.2% of participants reported no pain, 20.8% had very mild pain, 45.8% had moderate pain, and 4.2% experienced severe pain. Weak correlations were observed between neck pain and disabilities, with 33.33% of participants able to care for themselves without pain, 62.50% able to care for themselves with extra pain, and 4.17% finding personal care difficult and slow. Regarding headaches, 16.67% reported no headaches, 20.83% had slight headaches infrequently, and 62.50% experienced moderate headaches frequently. Conclusion: The study concluded that a significant number of university students suffer from neck pain due to prolonged computer use, with most experiencing mild to moderate pain. Preventive measures, including ergonomic interventions and educational initiatives on proper posture and taking breaks, are essential to reduce the incidence of neck pain and improve the quality of life for computer users.

Temporomandibular joint and cervical spine disability assessment in people with hypermobility joint syndrome.

Temporomandibular disorders (TMDs) and cervical spine problems are a growing public health issue, as they increase the risk of disability in people with hypermobility joint syndrome (HJS). The present study aimed to assess the prevalence of TMD symptoms, and cervical spine and TMJ disability in HJS patients. A survey was conducted among physical therapy students (mean age: 21 years). The study comprised 2 stages. The 1st one was HJS assessment (the Beighton scale and the Brighton criteria). Based on the assessment, 56 HJS subjects were enrolled for the study. The control group (CG) consisted of 60 HJS-free subjects, according to the aforementioned criteria. The 2nd stage of the study involved conducting a self-administered questionnaire on the prevalence of TMD symptoms. Both the TMD disability questionnaire (TMD-Q) and the neck disability index (NDI) scores were recorded. Pain intensity was assessed using the numeric rating scale (NRS). The HJS group showed higher NRS scores (p < 0.001). Headache, neck and shoulder girdle pain, and temporomandibular joint (TMJ) pain were found to be more severe in almost each patient from the HJS group as compared to CG. Those individuals had a greater degree of disability on the TMD-Q and the NDI scales (p < 0.001). The HJS group showed significant positive correlations between the TMD-Q and NDI scores (p = 0.0035), and between the TMD-Q and TMJ symptom questionnaire scores (p = 0.0047). A significant positive correlation between the NDI and TMJ symptom questionnaire scores was found both in the HJS group (p < 0.001) and CG (p < 0.001). The HJS bearers tended to obtain higher TMJ and cervical spine disability scores, at the same time reporting increased headache, neck and shoulder girdle pain, and TMJ pain intensity. Therefore TMJs should be carefully examined for possible signs of dysfunction in HJS subjects prior to dental or prosthetic treatment. According to our data, TMJ and cervical spine disability assessment should be included as a routine practice in the case of HJS patients, who should remain under the long-term care of a multidisciplinary team of doctors and therapists.

The quality of life after Anterior Cervical Discectomy and Fusion

Cervical discopathy is commonly associated with pain in the cervical spine which may affect patients’ quality of life. If conservative treatment fails to relieve the pain for at least 6 months and/or if neurological deficit progresses, the surgical treatment is taken under consideration. The aim of this study was to evaluate health-related quality of life (HRQOL) and disability of patients after single- and multi-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages. The study evaluated how ACDF influenced particular aspects of patients’ quality of life in the context of radiological outcome. The study included 30 consecutive patients with single- or multi-level cervical disc herniation. Patients underwent clinical and radiological evaluation before and one year after the ACDF procedure. For each patient, we assessed the severity of cervical pain with a numerical rating scale (NRS) and filled the neck disability index questionnaire (NDI). The health-related quality of life was assessed with the Polish version of 36-Item Short Form Survey (SF-36). A significant decrease in all NDI aspects indicates a significant improvement after surgery. The quality of life in all aspects assessed with SF-36 scale was also improved. A moderate decrease in cervical spine mobility coexisted with a good outcome of the neurosurgical procedure. In the opinion of patients, the most important aspect after the cervical spine surgery is the reduction of pain severity. ACDF surgery is an effective method to reduce the severity of pain in patients with degenerative disc disease. ACDF improves the quality of patient’s life. According to the study results the physical role improved most significantly; the least improvement was noted in role-emotional aspect. Up to 83% of patients achieved a reduction of the NDI index by 5 or more points after surgical treatment which proves the high effectiveness of the surgical treatment. No statistically significant difference was noted between patients with single and multi – level discopathy. Up to 97% of patients who underwent ACDF reported a significant decrease in pain severity measured with NRS.

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BackgroundChronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.MethodsDatabases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.ResultsA total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient’s head forward posture appeared to be corrected after scapular treatment.ConclusionScapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

Prevalence and Association of Neck Disability Index (NDI) with Forward Head Posture (FHP) among Pharm D Students

Background: Forward Head Posture (FHP) is a prevalent condition characterized by the anterior positioning of the cervical spine, leading to increased cervical lordosis. This posture has been associated with various musculoskeletal disorders, particularly among students who spend prolonged periods in sedentary activities, such as reading or using computers and smartphones. The relationship between FHP, the Neck Disability Index (NDI), and the Craniovertebral (CV) angle is crucial for understanding the impact of this postural deviation on neck disability. Objective: The study aimed to determine the prevalence of FHP among Pharm-D students at the Margalla Institute of Health Sciences, Rawalpindi, and to assess the association between the NDI and CV angle in this population. Methods: A descriptive cross-sectional study design was employed, involving 169 Pharm-D students selected through convenient non-probability sampling. The ON Protractor application was used for photogrammetric measurements of the CV angle, while the NDI questionnaire assessed neck disability. Data analysis was conducted using SPSS version 25, with correlation coefficients calculated to explore the associations between FHP, NDI, and CV angle. Results: The prevalence of FHP among the participants was found to be 84%. The majority of students (63.3%) exhibited light disability according to the NDI. The mean CV angle was 41.49 degrees in standing and 41.5 degrees in sitting positions. No significant correlation was observed between the CV angle and NDI (r=0.357 in sitting and r=0.162 in standing positions), indicating that the degree of FHP was not directly related to the level of neck disability. Conclusion: FHP is highly prevalent among Pharm-D students, with a significant proportion experiencing light neck disability. However, the study found no significant correlation between the severity of FHP (as measured by the CV angle) and neck disability. These findings underscore the need for targeted interventions to address FHP and prevent neck disabilities in this population.

Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study

BackgroundThe vast majority of people have experienced the problem of back pain at least once in their lives for a variety of reasons. It is well known that regular physical activity at a moderate level has a number of health benefits regardless of age or gender with positive effects on the musculoskeletal, cardiovascular, respiratory or nervous systems improving fitness levels. During the pandemic, Poland experienced one of the longest periods of school lockdown in Europe. In Portugal, this period was considerably shorter. The aim of this study was to determine the level of physical activity and back pain as well as relationship between physical activity and back pain in a group of Polish and Portuguese students in the following year the COVID-19 pandemic.MethodsThe study was conducted via the Internet among students from Poland and Portugal (398 respondents − 229 from Poland and 169 from Portugal) in October 2022. In the pilot study, the International Physical Activity Questionnaire and The Oswestry Disability Index and Neck Disability Index questionnaires were used to assess the level of back pain.ResultsThere are no statistically significant differences in the level of physical activity and pain complaints of respondents from the two countries. At least half of the students do not report any pain complaints (median in some groups being 0). In the Portuguese men, there is a correlation between the level of physical activity and the Neck Disability Index score (p = 0.0304).ConclusionsThe following year, after the pandemic COVID-19 was declared, the prevalence of back pain among students in Poland and Portugal is still significant.

Randomised controlled trial assessing the effects of 6-week telerehabilitation exercise programme on chronic non-specific neck pain: a study protocol

Chronic non-specific neck pain is one of the most common musculoskeletal conditions affecting the work and lifestyle of those suffering from it. Physiotherapy interventions, such as strength training and stretching,...

Cervical spondylotic myelopathy and driving abilities: defining the prevalence and long-term postoperative outcomes using the Quality Outcomes Database.

Cervical spondylotic myelopathy (CSM) can cause significant difficulty with driving and a subsequent reduction in an individual's quality of life due to neurological deterioration. The positive impact of surgery on postoperative patient-reported driving capabilities has been seldom explored. The CSM module of the Quality Outcomes Database was utilized. Patient-reported driving ability was assessed via the driving section of the Neck Disability Index (NDI) questionnaire. This is an ordinal scale in which 0 represents the absence of symptoms while driving and 5 represents a complete inability to drive due to symptoms. Patients were considered to have an impairment in their driving ability if they reported an NDI driving score of 3 or higher (signifying impairment in driving duration due to symptoms). Multivariable logistic regression models were fitted to evaluate mediators of baseline impairment and improvement at 24 months after surgery, which was defined as an NDI driving score < 3. A total of 1128 patients who underwent surgical intervention for CSM were included, of whom 354 (31.4%) had baseline driving impairment due to CSM. Moderate (OR 2.3) and severe (OR 6.3) neck pain, severe arm pain (OR 1.6), mild-moderate (OR 2.1) and severe (OR 2.5) impairment in hand/arm dexterity, severe impairment in leg use/walking (OR 1.9), and severe impairment of urinary function (OR 1.8) were associated with impaired driving ability at baseline. Of the 291 patients with baseline impairment and available 24-month follow-up data, 209 (71.8%) reported postoperative improvement in their driving ability. This improvement seemed to be mediated particularly through the achievement of the minimal clinically important difference (MCID) in neck pain and improvement in leg function/walking. Patients with improved driving at 24 months noted higher postoperative satisfaction (88.5% vs 62.2%, p < 0.01) and were more likely to achieve a clinically significant improvement in their quality of life (50.7% vs 37.8%, p < 0.01). Nearly one-third of patients with CSM report impaired driving ability at presentation. Seventy-two percent of these patients reported improvements in their driving ability within 24 months of surgery. Surgical management of CSM can significantly improve patients' driving abilities at 24 months and hence patients' quality of life.

Comparison of McKenzie and Isometric Exercises on Neck Functions of Computer Users with Forward Head Posture

Introduction: Prolonged use of computer can lead to poor posture such as forward head posture (FHP). This posture is associated with imbalance and stiffness of the neck muscles, lack of postural awareness and inappropriate ergonomics, resulting in work-related musculoskeletal disorders. These disturbances can affect the performance and productivity of office workers. Postural awareness training, neck exercises, and modalities are interventions in FHP management. Research that compares the effectiveness of cervical McKenzie and isometric exercise on neck functional score in computer users with forward head posture has not been conducted.&#x0D; Methods: This research was a quasi-experimental. The participants, 24 computer users working at Kariadi Hospital, Semarang, were divided into 2 groups by purposive sampling receiving cervical McKenzie exercise (n=12) and cervical isometric exercise (n=12). Each group received different exercise. Neck functional score was assessed by Neck Disability Index (NDI) questionnaire before and after intervention. The mean differences before and after treatment, as well as between groups was compared statistically using paired t-test.&#x0D; Results: The mean NDI score in the McKenzie group after treatment showed an improvement of 7.84 ± 3.54 with p = 0.002. The mean NDI score in the isometric group after treatment also showed an improvement of 3.93 ± 3.75 with p = 0.004. The difference in NDI score improvement in the cervical McKenzie group was greater than the one in isometric group and statistically significant with p = 0.017.&#x0D; Conclusion: Cervical McKenzie exercise was proved to be more effective in improving neck functional scores in patients with FHP compared to cervical isometric exercise.

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Background: Sedentary lifestyle, age-related degenerative changes or traumatic injuries leads to cervical spine structural mal-alignment, which results in neck pain and other symptoms. Various therapeutic exercises and manual techniques have been proven to be beneficial in terms of managing these symptoms. This study aimed to determine the combined effects of cervical mobilization and post-isometric relaxation (PIR) technique on managing neck pain, cervical side flexion range of motion, and functional limitation in participants with mechanical neck pain linked with myofascial trigger points. Methods: This study followed a 2-arm, parallel-group, pretest-posttest randomized comparative design. Thirty participants with mechanical neck pain associated with myofascial trigger points aged 30.87 ± 4.45 years were randomly allocated to Groups 1 and 2. Group 1 received conventional intervention, PIR, and cervical mobilization techniques while Group 2 received conventional intervention and PIR technique only. Neck pain, muscle tenderness, cervical range of motion, and functional limitations were assessed using a visual analog scale, pressure pain threshold (PPT), goniometer, and neck disability index (NDI) questionnaire, respectively at baseline on day 1 and post-intervention on day 7, 14, and 21. Wilcoxon signed-rank test and the Mann–Whitney U test evaluated within-group and between-group analyses, respectively. Statistical significance was established at a 95% confidence interval, indicated by P &lt; .05. Results: Significant differences (95% confidence interval [CI], P &lt; .05) were observed within each group for all the outcomes scores when compared to the baselines across multiple time points. Significant variations were observed between the groups when comparing visual analog scale and NDI scores at weeks 1, 2, and 3 post-interventions. In contrast, insignificant differences (95% CI, P &gt; .05) were observed for side flexion range of motion and PPT compared at weeks 1, 2, and 3 post-interventions except for PPT at week 3 post-intervention (95% CI, P &lt; .05). Additionally, Cohen d test revealed the superiority of group 1 over group 2 in reducing pain and functional limitations and improving cervical side flexion range of motion and PPT. Conclusion: The combination of cervical mobilization and Post-isometric relaxation techniques was discovered to effectively alleviate neck pain and enhance functional abilities when contrasted with the application of post-isometric relaxation alone in patients with mechanical neck pain linked with myofascial trigger points.

Comparison of Treatment Outcome of the Effectiveness of Isometric Exercises as Compared to General Exercises with Cervical Spine Mobilization in The Management of Chronic Non Specific Neck Pain

The purpose of this study was to evaluate the “effectiveness of isometric exercises as compared to general exercises along with cervical spinal mobilization to reduce pain, disability and to increase range of motion in chronic non-specific neck pain”For this randomized controlled experiment total 32 patients (16 in each group) with chronic non-specific neck pain were recruited from physiotherapy Ward Mayo Hospital Lahore, Department of Physiotherapy King Edward Medical University Lahore between October, 2019 and March, 2020. Simple randomization method was used to assign participants into isometric exercise group and general exercise with cervical spine mobilization group. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises with cervical mobilization group performed active range of movement exercises for all neck movements. Patients in both groups received 4 supervised treatment sessions per week for 6 weeks. Visual Analogue Scale (VAS), Neck disability index Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 6 weeks.Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001for isometric exercise group, p = 0.05 for general exercises group and p= &lt;0.001 for range of movement. However, mean improvements in post intervention VAS score and Neck disability index Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non- specific neck pain however; isometric exercises are clinically more effective than general exercises with cervical spine mobilization.

The Prevalence of Neck and Back Pain among Paramedics in Poland.

Neck Pain (NP) and low back pain (LBP) are ubiquitous musculoskeletal conditions and some of the major causes of disability worldwide. The aim of the study was to assess the incidence and risk factors of back pain among paramedics and their correlation with the nature of work, anthropometric features and the level of recreational physical activity. A group of 201 individuals (39 females (19.40%); 162 males (80.60%)), licensed to practice as paramedics in Poland completed a questionnaire containing the author's interview as well as the Neck Disability Index (NDI) questionnaire and the Revised Oswestry Disability Index (ODI). Among the examined paramedics, 92% of the subjects reported the presence of back pain in different parts of the spine (36% C; 17% Th; and 85% LBP). The pain intensity, determined by VAS, was on average 4.26 (SD 1.77). The level of disability, assessed by NDI, was 7.67 (SD 5.73) on average, while the ODI was 7.51 (5.90). Work-related spinal strain has a major impact on the intensity and incidence of spinal pain. Spinal pain in paramedics mainly occurs in the lower back.

The “Cristo Re” hospital experience on telerehabilitation for treatment post thyroidectomy neck pain

Abstract Background Thyroidectomies are one of the most frequently performed endocrine surgical procedures and are mostly consequent to thyroid cancers with about 80% of patients develop neck pain and stiffness. For better management in a public health setting, Cristo Re Hospital in Rome has designed specific physiotherapy based on selective stretching and strengthening of neck muscles combined with breathing. Methods The study enrolled 26 patients with a mean age of 51.2 years: 20 were treated with total thyroidectomy and 6 with thyroid lobectomy. Follow-up was performed at 1 day, 1 week and 1 month after surgery. We used for assessment: Visual Analog Scale (VAS), Neck Pain and Disability Scale-I (NPDS-I), Short Form-12 (SF12), Disability of the Arm, Shoulder and Hand (DASH), Neck Disability Index Questionnaire (NDI). The patients performed 10 therapeutic sessions: the first in the hospital on the first post-surgery day, the others in telerehabilitation 3 times a week (40 min. each) for 3 weeks. A nonparametric Friedmann test was analyzed the differences between the scale averages at T0/T1 and T2. Using case-control analysis the effects of treatment duration (&amp;lt;vs&amp;gt;90 min.) were assessed with the U-Mann-Whitney test. Results A statistically significant improvement was shown in the Physical Component Summary- SF12 at 1 week and 1 month after treatment (+3 pts at T1, +13.2 at T2 p &amp;lt; 0.001), while no significant changes in the Mental Component Summary. The averages of NPDS-I, NDI and DASH also decreased at T1 and T2 demonstrating the effectiveness of the protocol (-37.7 median points,-18.3 mp,-34.5 mp,-35 mp, respectively p &amp;lt; 0.001). No significant change in VAS scale at T1 and T2 and in patients treated for more or less than 90 minutes. Conclusions This protocol is useful for reducing neck pain and improving quality of life and can be recommended as a therapy after thyroidectomy with a strong reduction in cost and morbidity, being able to treat patients even in telerehabilitation. Key messages • Therapy after thyroidectomy that, by being able to treat patients even in telerehabilitation, reduces hospitalization rates, costs, and morbidity due to neck pain, with increased quality of life. • New low-cost methodology for neck physiotherapy after thyroidectomy, also performed in telerehabilitation, which improves quality of life and ability of movement while greatly reducing pain.

Use of transforaminal epidural blocks in patients with radiculopathy caused by herniated disc of the cervical spine

Aim of the research. To study the efficacy and safety of treating patients with cervical radicular pain that is resistant to conservative treatment. Material and methods. The results of treatment of 30 patients with herniated discs of the cervical spine and persistent radicular pain syndrome, who had an indication for surgical treatment, were studied. All subjects underwent transforaminal epidural block (TEB), and in case of its low efficiency, the patients were offered surgical treatment. The patients'condition was assessed in dynamics over 2 years, including on the basis of indicators of the visual analog scale (VAS), the Neck Disability Index (NDI) questionnaire, and motor dysfunction in the limb according to the MRC Scale for Muscle Strength (MRC). Results. After 1 month: 21 (70 %) patients noted a significant (at least 50 %), persistent decrease in the intensity of radicular pain during the first month after TEB; a decrease in NDI values was noted in all patients. In 83.3 % (n-10) of the patients, there was a complete recovery of motor function in the limb. Two (6.7 %) patients underwent surgical treatment. After 24 months: All patients maintained a decrease in NDI scores (median 4 [0;6]). In 21 (70 %) patients, a stable positive effect from the conducted TEB remained. Four (13.3 %) patients were operated on, while five (16.7 %) patients refused surgical treatment and continued conservative treatment with a positive effect over time. Thus, all patients showed a significant decrease in the intensity of radicular and local pain in the neck with a median of 0 [0;0]. A complete restoration of muscle strength was found in all patients with moderate paresis of the arm before manipulation (n-12). Only 5 patients (16.7 %) retained periodic moderate (not exceeding 3 points by the VAS) local pain in the neck, and four (13.3 %) patients noted periodic, mild (not exceeding 3 points by the VAS) radicular pain. Conclusion. The use of TEB in the treatment of patients with radiculopathy caused by herniated discs of the cervical spine prevents the need for surgical treatment in 70 % of the patients, while maintaining a high quality of life.